Perioperative nutritional support with beta-hydroxy-beta-methylbutyrate, arginine, and glutamine in surgery for abdominal malignancies

Noriko Wada, Yukinori Kurokawa, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Hiroshi Wada, Makoto Yamasaki, Kiyokazu Nakajima, Hidetoshi Eguchi, Shuji Takiguchi, Masaki Mori, Yuichiro Doki

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3 Citations (Scopus)

Abstract

Although beta-hydroxy-beta-methylbutyrate (HMB), arginine (Arg), and glutamine (Gln) may contribute to wound healing, no prospective studies have investigated the efficacy of a compound consisting of HMB, Arg, and Gln (HMB/Arg/Gln) for reducing wound complications following open abdominal surgery. Objective. This study evaluates the usefulness of perioperative nutrition using HMB/Arg/Gln in patients who were scheduled to undergo open surgery for abdominal malignancies in a randomized controlled trial. Materials and Methods. Patients scheduled for open surgery for abdominal malignancies were randomized to receive HMB/Arg/Gln (1.2 g HMB, 7 g L-Arg, and 7 g L-Gln) or placebo (isocaloric juice). The supplements were provided once daily for 3 days preoperatively and once daily for 7 days postoperatively. The primary endpoint was the incidence of wound complications. Secondary endpoints included the incidence of other complications, postoperative duration of hospital stay, total-body skeletal muscle mass, handgrip strength, and skin water content. Results. Sixty-one patients were randomly assigned to either the HMB/Arg/Gln (n ≤ 31) or the placebo (n ≤ 30) group. One patient in the HMB/Arg/Gln group was ineligible because laparoscopic surgery was performed; thus, 60 patients were analyzed. The incidence of wound complications (20%) was the same in both groups (P ≤ 1.000). There were no significant differences in the incidence of other complications, body composition, handgrip strength, or skin water content between the 2 groups. Serum growth hormone (GH) levels were significantly higher for patients whose total intake was > 80% of planned volume in the HMB/Arg/Gln group. Conclusions. The incidence of wound complications would not be reduced by perioperative HMB/Arg/Gln administration in patients who underwent open surgery. The efficacy of HMB/Arg/Gln for increasing serum GH levels needs to be validated in another large-scale randomized controlled trial.

Original languageEnglish
Pages (from-to)251-256
Number of pages6
JournalWounds
Volume30
Issue number9
Publication statusPublished - Sep 1 2018
Externally publishedYes

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Medical–Surgical

Cite this

Wada, N., Kurokawa, Y., Tanaka, K., Miyazaki, Y., Makino, T., Takahashi, T., ... Doki, Y. (2018). Perioperative nutritional support with beta-hydroxy-beta-methylbutyrate, arginine, and glutamine in surgery for abdominal malignancies. Wounds, 30(9), 251-256.